Friday, November 20, 2015

ICU patients often experience similar lingering emotional and psychological effects of delirium, according to a new study published in the November issue of the American Journal of Critical Care.

The research team interviewed 10 adult patients who had been diagnosed with delirium while in the ICU after they were no longer delirious. The overarching themes in patients’ reports were:

Lack of recall about their experience, often accompanied by feelings of guilt and shame about their behavior while delirious;

Feeling disconnected while delirious and unable to communicate or move, leading to frustration and fear;

Vivid hallucinations, disorganized thinking and periods of disorientation; and

Believing they or their family were in danger while they were delirious.

The study also looks at the importance of critical care nurses in early recognition and treatment of patients with delirium, and how that can positively influence patient outcomes. Nurses also help patients and families deal with the aftermath of delirium in the ICU, particularly the psychological effects, according to the researchers.

This work mirrors that of INQRI grantees Michele Balas and William Burke who conducted research on patients on ventilators in ICUs, who are typically at high risk for delirium and weakness. Their research focused on preventing complications in ventilated patients through use of the "Awakening and Breathing Coordination, Delirium assessment and management and Early Exercise and progressive mobility (ABCDE)" bundle.

Balas and Burke led a team to implement, analyze and disseminate an evidence-based, nurse-led, inter-professional, multi-component program focused on improving the care and outcomes of critically ill adults. Their "Implementing the ABCDE Bundle at the Bedside" was selected as the American Association of Critical-Care Nurses' first PEARL (Practice, Evidence, Application, Resources and Leadership) web-based tool.

Click here to learn more about the Balas-Burke project "Implementation and Dissemination of an Interdisciplinary Nurse-Led Plan to Manage Delirium in Critically Ill Adults."

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About INQRI

The primary goal of the Interdisciplinary Nursing Quality Research Initiative (INQRI) is to generate, disseminate and translate research to understand how nurses contribute to and can improve the quality of patient care.

The program supports interdisciplinary teams of nurse scholars and scholars from other disciplines to address the gaps in knowledge about the relationship between nursing and health care quality.